Have any drug companies been forced to pay damages because of their vaccines due to these erroneous studies? I generally have no sympathy for the giant drug corporations, but this debate has been raging long enough that I would not be surprised if this has happened.
The Special Masters (judges) who have ruled on vaccine cases to date have not based their rulings on this study.
Who was it that did this study?
Brian Deer is a British Journalist who has pulled together data from multiple sources to compile the published report. The editors of the British Medical Journal also wrote an editorial based on their opinions.
Since the autism-vaccine-mercury link has been debunked (yet again), what sorts of treatments should a parent look into for an autistic child? Seems the whole DAN! heavy metals protocols would also be suspect. My child is 6 years old and ASD--he is improving, but still compromised socially and in speech. Anything other than speech therapy/social skills groups we should consider? He doesn't have a seizure disorder (that we know of). There's so much out there that people try that it's hard to know what to do sometimes. Thanks.
It is very important for families of children with autism to examine therapies based on scientific evidence - that is why the current controversy is so important. The Peer Reviewed scientific literature (medical and scientific journals) depend on both editors and volunteer scientists to review the studies submitted for accurate interpretation and ethical conduct.
Children with autism benefit from intervention that reinforces communication: for some who do not have speach that means sign or picture exchange, for those who speak that may mean conversation. They benefit from intervention that directly teaches social interaction, developmental skills and helps the family generalize these skills.
Medical work up includes a complete history and physical to guide further evaluations. About 10% of children with autism have underlying genetic predisposition that can be identified using current testing. It is important for families to have a developmental specialist to help them and their primary care provider navigate available therapies
The increased identification of children - and previously unidentified adults - adults with autism spectrum disorders (ASDs) may relate to a broader definition (1994), improved screening and awareness, the availability of services, OR the possibility that prevalence is actually increasing. the Diagnostic and Statistical Manual published discrete criteria for ADHD, ASD and other behaviorally define disorders so there is not widespread misdiagnosis. It is important to have discrete criteria so treatment can be studied and causes understood.
Studies that are funded through the National Institutes of Health often are required to make the data available for outside analysis after the authors have completed their work. The reason for Peer Review by anonymous scientists prior to publication is to have someone else make certain that the claims are supported by the data presented.
Celebrities have a tremendous social responsibility when they advocate for causes . Celebrities set social examples for young people in their personal behavior as well. In addition to celebrities, the media has a responsibility to present the evidence that contributes to opinions offered - especially if there is an impact on public health.
I have not seen this episode.
One thing I've never seen is the statistics about autism rates since they took the mercury out of most childhood vaccines. Have rates gone down in the last 8 years? Do we have stats on that? Thanks!
The rates of autism continue to rise. We do not know if this represents the true rate of the disorder in the population or if pediatricians and parents are more aware of the symptoms resulting in improved diagnosis across the age span and across intellectual abilities.
Mercury was never in the MMR vaccine.
I was watching CNN last night and a fellow names JB Handley claims that there are new studies out from Stonybrook and Pittsburgh that do find a link between some vaccines and autism. He also claimed that the "correct" study, one done comparing children who received absolutely no vaccines versus those who did, has not been done and that is the only type of study that could put this issue to rest. In your opinion, how much water does the latter argument hold? Does he have a point? Do scientists need to design and execute better studies on this?Also, are the new studies he cites any good? It's one thing to claim that a study proves your point, but it doesn't necessarily mean it's a good study. There are published studies that claim HIV doesn't cause AIDS, but I wouldn't want to hang my hat on any of those. Where is the reasoned voice that out there that can discuss these issues and bring some reasoned debate?
It would be unethical to withold vaccine from children prospectively since the disorders they prevent are not eradicated. Infants die from pertussis, there was an epidemic in LA reported last year that sent one infant to the hospital after an unimmunized child exposed over 800 people to measles with 11 documented cases in unimmunized children.
Children who do not get immunized because of personal or religious beliefs may not be a representative control group. The size and expense of a randomized prospective study would be prohibitive and with holding vaccines unacceptable by medical standards. Studies in Denmark, where vaccine is elective, did not find an increased rate of autism in children who were vaccinated.
Yes, this is considered a case series. It is not the level of scientific design that would typically cause a change in medical practice or public policy
This is an excellent point: for us to practice evidence based medicine we need to be able to believe the evidence.
Peer review assumes a certain trust that the data was collected under the auspices of an Institutional Review Board that protects human subjects and ensures ethical study design. It assumes that the investigator submits accurate data.
Honesty. Typically investigators publish "erratum" when errors are detected in data that were published, or when further analyses indicate different results. Discussion is desirable in science - few "facts"emerge as facts but require an iterative process of research and confirmation by other studies.
Confirmation and further study is critical
Isn't it more likely that autism, etc., is a result of parental use of recreational drugs, leading to harmful mutations later passed down to the embryo in its genetic inheritance?
While case series have identified an association of autism with certain prescription drugs (thalidomide, valproic acid, misopristol), studies to date have not identified an association with prenatal use of opiates, tobacco, marijuana or alcohol. This is not to say that prenatal exposures are NOT associated with developmental disabilities: tobacco decreases IQ and increases the risk for ADHD, alcohol is associated with decreased IQ and ADHD. Prenatal exposures to environmental agents may indeed impact gene function and result in autism and other developmental disabilties. A combination of epidemiologic studies and basic science is necessary to figure this out
Given what we know now - ethyl mercury vs. methyl mercury, and that doctor's patent for a non-thimerosol (spelling?) MMR vaccine, shouldn't the Lancet have done more due diligence before publishing that paper? I have lost any high regard for that journal because of the harm that publishing that paper did to Public Health. Even though they retracted it now, some still say, "it was published in a leading journal!
Medical journals require contributors to disclose financial interests that they may have in a product or conclusion. This results in public disclosure so the reader can identify potential bias. Disclosure should alert the reviewers and the editors for potential conflict of interest.
With evidence that vaccines are not the etiology (cause ) of autism, there may be a shift of scientific interest to other environmental exposures that might impact gene function in individuals predisposed to autism. There might be an increased interest in other immunologic events in gestation that might affect brain development. These might be productive avenues for research to be directed
NDAR (National Data Base for Autism Research) contains data from NIH funded studies. It does not contain all data collected, but NIH can be approached for analysis of this data for peer reviewed publication.
Agreed
Studies should be examined for appropriate sample size to reach the conclusions generated, careful and accurate diagnosis of patients, use of valid and reproduceable outcome measures, appropriate statistical analysis, and (if an intervention trial) reproduceable intervention used in standard dosing and provided in a double blind placebo controlled fashion
The measles titre measures his ability to form immunity and response to the vaccine. Studies have not demonstrated that measles titers are elevated or causative in autism.
The yeast hypothesis has not been demonstrated as causitive. It is based on the observation that yeast "metabolites" were present in urine in two brothers with autism. Case series of GI studies (including Dr. Wakefield) did not report yeast overgrowth in the intestines of children with autism. There are no studies in the medical literature supporting treatment of yeast overgrowth in autism. With that said, there is evidence that probiotic use may have benefit in some children related to GI symptoms and other pediatric disorders other than autism.
Research regarding behavioral effects of diet is ongoing
The CDC reported 131 cases of measles in 2008, of those there were no deaths but several hospitalizations. Of the 11 cases reported in the LA epidemic last year, one hospitalization and no deaths were reported. Measles continues to be a major cause of childhood death and neurologic disease in the developing world. In this age of travel and immigration it is important to be vigilant in our protection of children.
Where is Dr. Wakefield practicing now? With this proof of his intentional fraud, done for financial gain, he should not be allowed to continue his "research" in the United States either. Do we know where he is and what institution he's affiliated with? Is it possible that the United States can withdraw his work visa based on this new evidence?
Dr. Wakefield was originally associated with Thoughtful House in Texas. To my knowledge he terminated his association with that organization prior to the current increase in controversy.
Obviously, parents want the best for their children and frequently discuss medical decisions with their pediatricians. What responsibility do healt- care professionals have in helping parents understand the science behind vaccinations so parents understand they're safe? Seems like many peds are willing to let patients go unvaccinated to retain business.
Excellent question. The concept of the "medical home" for children with special health care needs advocates for ongoing collaboration in the care of children with disabilities between their parents and pediatricians. The AAP supports protecting children from vaccine preventable illness and educating families regarding both vaccines and autism.
My observation is the opposite, that many clinicians will adjust the immunizaiton schedule to retain patients and get children immunized.
Current data suggests that up to 10% of autism is related to identifiable genes. However, given the variability in presentation, few of these genes reliably result in developmental disability. This limits the use of prenatal testing for prediction. Research is ongoing that examines combinations of genes that might increase prediction in families in whom there is already one child with autism.
The causes of autism include prenatal events - either genetic, environmental or the combination of the two so research in this area is important
I think that editors and reviewers will look more closely at all data that is submitted
I believe the courts in the UK have examined the evidence and ruled accordingly
The answerto this would not be evidence based!
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